Banty Dental Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DDS100420 Issued in CA

Legal business name

BANTY DENTAL CORPORATION

Doing business as

SoLA Kids Dental

Practice address

5971 S Main Street
Los Angeles, CA 90003

Phone

(323) 325-5641

NPI assigned

Aug 13, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Laura Banty, DMD

Title

President

Phone

(843) 557-4335

Specialties & licenses 1

Addresses

Other names 1

• SoLA Kids Dental Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538265600000",
    "number": "1720567548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 W CHANNEL RD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904021107",
            "telephone_number": "843-557-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5971 S MAIN STREET",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90003",
            "telephone_number": "323-325-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANTY DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-13",
        "last_updated": "2018-09-30",
        "status": "A",
        "authorized_official_last_name": "BANTY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-557-4335",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "DDS100420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SoLA Kids Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SoLA Kids Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eliza Bantolo, PT
• Novo F Bantolo, PT
• Lorena Tulud Bantug, NP
• Diana Isabel Bantugan
• Leonora B Bantugan
• Adrian Banuelis
• Andrew Banuelos Bugarin
• Saul Banuelos Luna, RT1430520226
• Adriana Banuelos
• Albert Banuelos

• Dental Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.